New York Temporary Disability Insurance Program for Pregnancy

New York is one of the few states that has a temporary disability insurance (TDI) program, which requires employers to provide short-term disability insurance for their employees. New York law requires employers to provide coverage by either purchasing insurance (from a private carrier or the state) or by self-insuring.

In either case, employers are required to provide partial wage replacement, for up to 26 weeks, to employees who are temporarily unable to work due to disability caused by an off-the-job injury, illness, or disability, including pregnancy and childbirth. (On-the-job injuries are handled by the workers' compensation program.)

In addition, New York's Paid Family Leave Policy provides job protection, continued health insurance, and up to 12 weeks of paid leave to workers who need time off to:

• bond with and care for a new child (including adopted and fostered children).
• take care of a family member who is seriously ill or injured, or
• care for loved ones when a spouse, domestic partner, child, or parent is deployed abroad on active military service.

For more information on the paid leave program, read our article on maternity and parental leave in New York.

Which New York Employers Must Provide TDI?

Virtually all employers in the state of New York must provide TDI (and paid family leave benefits). The New York TDI rules require the following employers to provide coverage:

• Employers that have had at least one employee on each of 30 days in a calendar year must provide coverage four weeks after hitting the 30-day mark. (The 30 days don't need to be consecutive, and it doesn't need to be the same employee.)
• Those who employ domestic or personal employees (including in a private home) must provide coverage if those employees work at least 40 hours a week for the same employer.
• Employers that are successors to a covered employer must immediately provide TDI.

An employer can also elect to provide coverage, even if not legally required to do so, by filing an Application for Voluntary Coverage.

Who Pays for TDI in New York?

Employers foot most of the cost of the TDI. Employers can collect a small amount from employees to help fund their insurance obligation—up to 60 cents per week. But employers aren't required to collect employee contributions.

If you have more than one job at the same time, and your total earnings are more than $120 per week, you can ask your employers to adjust your contributions in proportion to your earnings. The combined contributions still can't be more than 60 cents per week.

You might be asked to contribute more to certain approved disability plans, but only if you agree and if the plan is a good value for the money.

Which Employees Are Covered Under New York's TDI Program?

As an employee, you're entitled to coverage if you've suffered an off-the-job illness, injury, or other disabling event (including pregnancy) and any of the following are true:

• You've worked for a covered employer for at least four consecutive weeks.
• You worked for a covered employer within the last six months but were collecting unemployment benefits when you became disabled.
• You work for a successor of a covered employer.
• You're a domestic or personal employee who works at least 40 hours per week for one employer, or
• You work for an employer that has voluntarily elected to provide coverage.

(Learn about the few specific jobs that might make you ineligible for New York's TDI and family leave coverage.)

New York's Pregnancy Disability Coverage

Pregnancy is one of the medical conditions covered under New York's temporary disability insurance, as are any pregnancy-related illnesses or complications. You're entitled to coverage only for the time when you're actually unable to work due to pregnancy or childbirth.

If you're pregnant, you're entitled to disability for up to four weeks before your due date and up to six weeks after giving birth (eight weeks if you delivered by Caesarian section). If you need more TDI, you might have to submit additional medical documentation to support your claim. But you might be automatically eligible for paid family leave once your TDI has ended.

How Much TDI Can I Get?

If you're eligible for TDI, your benefit:

• is up to 50% of your average weekly wages during the last eight weeks you worked before becoming disabled (or taking paid leave)
• can't be more than the maximum benefit amount of $170 per week, and
• is subject to Social Security and Medicare taxes.

Benefits aren't payable for the first seven days you miss work. You can collect New York TDI for up to 26 weeks (during any consecutive 52 weeks), and the combined amount of disability and family leave you can get is also limited to 26 weeks. You can't get both TDI and paid family leave at the same time.

How to File a TDI Claim in New York

For short-term disability coverage (TDI), you must file a claim within 30 days after you become disabled. You'll need to complete a Notice and Proof of Claim for Disability Benefits (Form DB-450). You can get the form from your employer, your employer's insurance carrier, or your health care provider, or download it using the link above.

You must complete and sign Part A, "Claimant's Statement," and have your health care provider complete and sign Part B, "Health Care Provider's Statement." If you became disabled less than four weeks after the last day you worked, you'd need to file your Form DB-450 with your employer or your employer's insurance carrier.

If you're receiving (or eligible to receive) unemployment benefits and your disability started more than four weeks from the last day you worked, you'll need to mail your completed Form DB-450 to the Workers' Compensation Board, Disability Benefits Bureau, PO Box 9029, Endicott, NY 13761-9029.

If you're getting unemployment and your disabling injury was the result of a no-fault auto accident or the negligent actions of a third party, you'll need to include a Form DB-450.1, called a "Claimant's Statement Regarding No Fault or Personal Injury."

What to Do if Your TDI Claim Is Denied

If your TDI claim is denied, you must receive a Notice of Rejection from your employer, the insurance carrier, or the Special Fund for Disability Benefits within 45 days of receiving your claim. You have the right to a review by the New York Workers' Compensation Board (which oversees the state's short-term disability (TDI) program). Follow the instructions on the back of the Notice of Rejection.

If you've been discriminated against because of your pregnancy, or your claim for benefits is unfairly denied, you might wish to consult with an experienced disability employment attorney.

_{Updated October 24, 2022}